Diagnosis and differential

differential diagnosis

• myoclonic jerks
• mannerisms
• stereotypies (especially in the context of autistic spectrum disorders) (1)

diagnosis

Tourette's syndrome (TS) is often an under diagnosed condition which can result serious distress and compromise health related quality of life (1,2).

Diagnosis of TS is made clinically

• patients tend to suppress tics inside the physicians room , hence the best time to look for tics is when the patient is walking into or out of the examination room
• current diagnostic criteria for Tourette's syndrome includes
  • at least two motor and one vocal tic (not necessarily concurrently)
  • presence of tics for at least 12 months
  • onset before age 18 years
  • tics not caused by the physiological effects of substances (such as stimulants) or other medical conditions (such as Huntington's disease)

Reference:

• (1) Cavanna AE, Seri S.Tourette's syndrome. BMJ. 2013;347:4964
• (2) Kurlan R.Clinical practice. Tourette's Syndrome. N Engl J Med. 2010;363(24): 2332-8